Kornimate/medical-research-clean huggingface dataset:
completely abdominal approach laparoscopic partial intersphincteric resection for rectal cancer

Conditions: Rectal Cancer

Summary: the conventional intersphincteric resection (isr) for low rectal cancer requires a combined abdominal and perineal approach, and followed with a handsewn coloanal anastomosis, which is time consuming and difficult to accomplish. a complete laparoscopic abdominal approach partial intersphincteric resection has been proved to be a safe and feasible alternative for low rectal cancer treatment, with the advantages of technical convenience and avoiding a permanent ostomy. but there are few reports concerning differences in clinical outcomes between patients with or without neoadjuvant chemoradiotherapy undergoing partial isr surgery. therefore, it is necessary to compare the functional outcomes (including anal and sexual function, and postoperative quality of life \[qol\]) and oncologic outcomes of patients who underwent completely abdominal approach laparoscopic partial isr surgery after neoadjuvant chemoradiotherapy, with those who received isr surgery directly. furthermore, the operation difficulty between the above two groups is also worthy of intensive study.

patients with ct1 to ct2 low rectal cancer are directly operated through completely abdominal approach laparoscopic partial isr surgery. patients with ct3 low rectal cancer are firstly treated with standard neoadjuvant chemoradiotherapy until down staged to yct1 to yct2. the postoperatively functional outcomes and oncologic outcomes between the two groups are compared, including anal and sexual function, qol and local recurrence rate. the operation difficulty between the above two groups is also investigated, including operation time, the intraoperative and postoperative complications, mesorectum integrity, time for mobilizing the intersphincteric plane, the intactness of the fascia of the levator ani muscle, pubis coccygeus, puborectalis, and external sphincter.

Eligibility criteria:
inclusion criteria: * biopsy-proven moderate or well differentiated adenocarcinoma * rullier classification of low rectal cancer (types ⅱ: juxta-anal tumor) * clinical staging: initially staged as t1 -2 or down staged to t1-2 after neoadjuvant chemoradiotherapy; exclusion criteria: * without signing informed consent, poor compliance * unfit for laparoscopy * other serious diseases not suitable for participating in this clinical trial * a degree of preoperative fecal incontinence * after preoperative neoadjuvant chemoradiotherapy, the sphincter function, sexual function and others involved in this trail are seriously affected
npwt reduction mammaplasty

Conditions: Healthy; Macromastia; Negative Pressure Therapy; Mammaplasty; Wound Healing

Summary: in this prospective, randomized, split-body control trial, we aim to compare complications, patient-reported outcomes, and cost differentials following reduction mammaplasty with prophylactic closed incision negative pressure wound therapy versus standard adhesive dressing.


Eligibility criteria:
inclusion criteria: * female patients * age 18 years or older * scheduled to undergo bilateral reduction mammaplasty with a wise pattern (anchor) incision and a superomedial, inferior, or central mound pedicle at medstar georgetown university hospital or medstar good samaritan hospital * able to comply with study procedures and follow-up visits exclusion criteria: * younger than 18 years of age * biologically male patients * scheduled to undergo unilateral breast mammaplasty * currently pregnant or lactating * use of steroids or other immune modulators known to affect wound healing * current smokers who have not paused for a minimum of 4 weeks prior to surgery * history of breast cancer * history of oncologic or reconstructive breast surgery * history of radiation to the breast * history of chemotherapy or hormone therapy * tattoos in the area of skin incision * skin conditions known to affect wound healing or scarring of the breast (e.g., cutis laxa) * significant history of scar problems (e.g., hypertrophic scarring or keloids) post-surgical incisions with active bleeding * exposure of blood vessels, organs, bone, or tendon at the base of the reference wound * known allergies to product components (e.g., medical or npwt tape) * unable to comply with npwt requirements, including those unable to present for postoperative follow-up * lactating at the time of surgery * require deviation from standard operative or closure techniques (e.g., staples, free nipple grafts) * considered part of a vulnerable population (adults unable to consent, infants, children, teenagers, pregnant women, prisoners) * experience intraoperative complications due to surgical complications not related to the npwt instrumentation (e.g., expanding hematoma)

Keywords: mammaplasty macromastia breast reduction negative pressure therapy
acute d2 receptor blockade induced neuronal network changes in human volunteers

Conditions: Imaging of the Brain and Antipsychotics; Neuronal Network Changes

Summary: to detect the effect of second-generation antipsychotic drug on the neural activity.

to detect functional correlation changes in the brain with anti-psychotic drug administration as compared to placebo, and b.) to measure if these changes correlate with the plasma level of anti-psychotic, and c.) to evaluate if these changes correlate with drug induced symptoms and changes in cognitive function.

Eligibility criteria:
inclusion criteria: * between 18 and 60 years of age * subject is competent to provide informed consent exclusion criteria: * mini mental status exam is less than 28 * past or current history of any psychotic illness in the subject or in first degree family members * self report of illicit drug use (except marijuana) in the past. use of marijuana during the last 3 month... * any use of antipsychotic in the past. * any neuro-anatomical lesions on previous brain imaging * any use of d2 receptor blocking agent (such as antiemetics) in the last two weeks. * any use of any psychotropic medications (ssri, mood stabilizers, benzodiazepines, stimulants) in the last month. * mri contraindications * any cardiovascular or cerebrovascular diseases or conditions that predispose patients to hypotension (eg. dehydration, hypovolemia, antihypertensive medication) * subjects with diabetes mellitus, metabolic syndrome, hepatic or renal impairment, seizure disorder and any neurological disorder * qtc interval longer than 450 ms for male and 470 ms for female * subjects who used any medications in the last two weeks (to avoid any possible drug-drug interactions) * pregnancy * individuals who are illiterate and/or visually impaired

Keywords: imaging risperidone placebo antipsychotic
initial antibiotics and delayed appendectomy for acute appendicitis

Conditions: Acute Appendicitis

Summary: several recent studies have examined the feasibility and benefits of nonoperative treatment of perforated appendicitis in children. one such study showed a trend toward longer operative times for patients randomized to immediate appendectomy, but no overall advantage. in another larger study, the costs of delayed appendectomy for perforated appendicitis were higher - in part related to readmissions in the interval (6-8 weeks). nevertheless, these and other studies have demonstrated the safety of delaying appendectomy for perforated appendicitis. emergency appendectomy is a well-established approach, and postoperative recovery in children is fast. nevertheless, from the onset of symptoms through the hospital stay and the postoperative recovery, appendicitis causes a disruption of a family's normal routine (absence from school and work) of up to 1-2 weeks. because this is an unplanned operation, patients have to wait until an operating room becomes available, or elective operations have to be placed on hold to accommodate the emergency operation. each year, more than 250 children undergo an appendectomy at hch. this represents 250 episodes of emergency surgery, or about one emergency add-on operation per working day. if an initial trial of antibiotics is safe for the treatment of appendicitis, converting an emergency operation into an elective, scheduled outpatient procedure may reduce stress and disruption of routine for patients and their families - and may allow better operating room planning for health care professionals and hospitals. the investigators hypothesize that initial antibiotic treatment of acute (non-perforated) appendicitis, followed by scheduled outpatient appendectomy, reduces the overall cost of treating the disease and results in greater patient and family satisfaction. this pilot study aims to establish the safety and feasibility of treating acute appendicitis with intravenous antibiotics, followed by outpatient oral antibiotics. patients and their families will be offered the possibility of initial nonoperative treatment and subsequent outpatient elective appendectomy in a nonrandomized, single arm study.


Eligibility criteria:
inclusion criteria: * maximum 48-hour-history of abdominal pain * diagnosis of acute appendicitis based on clinical, laboratory and/or radiologic criteria exclusion criteria: * duration of symptoms \> 48 hours * presence of an appendiceal abscess on imaging * clinical or laboratory suspicion of advanced appendicitis, peritonitis or perforation * significant comorbidities * inability or unwillingness to complete a 1-week course of oral antibiotics * allergy to penicillin

Keywords: appendicitis
ultrasound efficacy in moderate rheumatoid arthritis

Conditions: Rheumatoid Arthritis

Summary: the objectives of this research study are to determine the frequency of low synovitis scores by ultrasound in patients with rheumatoid arthritis in moderate or high disease activity and to compare physician treatment recommendations for patients before versus after receiving ultrasound results. participants will answer questionnaires about their disease activity and complete a musculoskeletal ultrasound in accordance with the study procedures.

the purpose of this research study is to determine whether ultrasound technology can improve treatment decisions for patients with rheumatoid arthritis who have elevated disease activity scores. to do so, the investigators will be evaluating rheumatoid arthritis patients with moderate to high disease activity and how ultrasound scans can reveal any new information about the severity of their arthritis. patients will answer questionnaires to gauge their disease activity as well as the depression, fatigue, and pain they experience as a result of their arthritis. the patients will then undergo an ultrasound examination to evaluate their synovitis levels, which will then be made available to their physician. physicians will be asked about their disease activity assessments and treatment recommendations before and after ultrasounds are performed.

Eligibility criteria:
inclusion criteria: * patients must meet the american college of rheumatology's 2010 criteria for rheumatoid arthritis. they must be undergoing treatment with a disease-modifying anti-rheumatic drug, and their clinical disease activity index (cdai) must be greater than 10 while their swollen joint count must be less than or equal to two. exclusion criteria: * patients with evidence of large joint (knee, hip, shoulder, elbow) disease activity, including warmth and swelling, and patients who have had a joint mri or musculoskeletal ultrasound in the past 3 months will not be eligible to participate in the study.

Keywords: ultrasound
efficacy and safety of xg-104 for the treatment of dry eye

Conditions: Dry Eye

Summary: the objective of this study is to assess the safety and efficacy of xg-104 ophthalmic solution compared to placebo for the treatment of the signs and symptoms of dry eye after a 4 week three times a day (tid) treatment period


Eligibility criteria:
inclusion criteria: * be at least 18 years of age * provide written informed consent * have a subject reported history of dry eye * have a history of use or desire to use eye drops exclusion criteria: * have any clinically significant eye findings that require therapeutic treatment, and/or in the opinion of the investigator may interfere with study parameters; * have worn contact lenses within 7 days of visit 1 or anticipate using contact lenses during the study; * have previously had laser-assisted in situ keratomileusis (lasik) surgery within the last 12 months; * have used restasis® within 30 days of visit 1; * have any planned ocular and/or lid surgeries over the study period; * be a woman who is pregnant, nursing or planning a pregnancy; * be unwilling to submit a urine pregnancy test at visit 1 and visit 4 (or early termination visit) if of childbearing potential. * have a known allergy and/or sensitivity to the study drug or its components * have a condition or be in a situation which the investigator feels may put the subject at significant risk, may confound the study results, or may interfere significantly with the subject's participation in the study; * be currently enrolled in an investigational drug or device study or have used an investigational drug or device within 30 days of visit 1; * be unable or unwilling to follow instructions, including participation in all study assessments and visits
music's effects on anxiety during epidural placement

Conditions: Anxiety; Satisfaction

Summary: the objective of the study is to determine if playing the song "weightless" by marconi union during labor epidural placement, decreases laboring parturient anxiety and improves satisfaction with the experience.


Eligibility criteria:
inclusion criteria * females ages 18 years and older committed to delivery by the obstetrical team (natural labor or induction of labor) * english speaking * able to give informed consent * having an epidural placed exclusion criteria * patient refusal * intrauterine fetal demise * imminent delivery * existing music use
intratumoral heterogeneity on [18f]psma and [18f]fdg pet/ct in predicting invasion and prognosis of prostate cancer

Conditions: Prostate Cancer (Diagnosis); Prostate-specific Membrane Antigen; Positron Emission Tomography (PET)

Summary: the purpose of this study is to analyze heterogeneity of prostate cancer（pca）based on the head-to-head imaging of prostate-specific membrane antigen (psma) and fluorodeoxyglucose (fdg) positron emission tomography computed tomography (pet/ct)

pet/ct examinations were performed on different days using siemens biograph mct pet/ct equipment. all patients were examined on the same scanner. patients were fasted for more than 6 h before \[18f\]fdg pet/ct examination, blood glucose was controlled below 11.1 mmol/l, \[18f\]fdg injection dose was 3.7 mbq/kg, and \[18f\]fdg pet/ct examination was performed after 60 min rest. \[18f\]psma-1007 injection dose was 3.7 mbq/kg, and pet/ct scan was performed 60 min after injection. to avoid interference of prostate lesion detection by active urine in the bladder, patients were asked to urinate or undergo forced diuresis before the start of the examination. the scan was performed from the top of the head to the base of the thighs. low-dose ct was taken with automatic milliampere-second 120 kv voltage scans with a matrix of 512 × 512 and a thickness of 5 mm, and pet/ct image acquisition was taken from 5-6 beds for 2-3 min each. ct data was used for attenuation correction at the end of the acquisition, reconstructed by the two-iteration method (21 subsets in total), and the true x +tof algorithm was applied to reconstruct the images. two nuclear medicine physicians with extensive experience in pet/ct interpretation evaluated the images using the lifex software v 7.1.0. both readers were blinded to both clinical and pathological data

Eligibility criteria:
inclusion criteria: * untreated patients with pca confirmed by prostate systemic pathological biopsy * patients underwent \[18f\]psma-1007 and \[18f\]fdg pet/ct and the imaging interval was less than one month. exclusion criteria: * patients received treatment at intervals of two imaging * imaging was less than 1 week after pathology biopsy

Keywords: fluorine-18-fluorodeoxyglucose heterogeneity
use of roflumilast to prevent exacerbations in fibrotic sarcoidosis patients (refs)

Conditions: Sarcoidosis

Summary: pulmonary sarcoidosis patients with fibrosis often develop recurrent episodes of bronchitis. these can lead to worsening of disease for both the short and long term. roflumilast has been shown to reduce the number of acute bronchitis episodes in patients with copd. drugs similar to roflumilast have been shown to help sarcoidosis. the current study is to determine if roflumilast will reduce number of episodes of bronchitis and help fibrotic sarcoidosis.

this will be a multicenter, double blind, placebo controlled study. patients would be randomized 1:1 to receive either roflumilast 500 mcg per day or placebo added to their current treatment regimen for twelve months.

Eligibility criteria:
inclusion criteria: 1. patients with sarcoidosis as defined by the american thoracic society criteria 2. patients with an fev1/fvc ratio of less than 80% 3. patients with fibrosis on chest x-ray and/or high resolution ct scan. 4. patients have had at least two exacerbations of their sarcoidosis in the prior year. an exacerbation is defined as an acute event requiring increase of prednisone with or without use of antibiotics. 5. patients must be on a stable dose of corticosteroids and other agents for their sarcoidosis at least 4 weeks prior to first visit. 6. for patients on prednisone alone, the dose has to be the equivalent of 5 mg prednisone a day. for those on other immunosuppressants, they can be on any dose of prednisone. 7. patients must be between ages of 18 and 70 years of age. 8. willing to take prednisone at increased dosage for exacerbations of their sarcoidosis. 9. patients must be able to provide written informed consent to participate in the study. exclusion criteria: 1. patients with known hypersensitivity to theophylline or pentoxifylline will not be eligible. patients with dose dependent nausea from these drugs may still participate in the trial. 2. patients will not be able to take theophylline or pentoxifylline during the time of the study. they will be allowed to take drugs for sarcoidosis including prednisone, methotrexate, azathioprine, leflunomide, hydroxychloroquine, thalidomide, infliximab, adalimumab, and rituximab. 3. patients with serum creatinine of greater than 3 mg/dl 4. patients with moderate or severe liver disease as defined child pugh class 3 or 4. 5. patients with unstable cardiac disease 6. patients with non cutaneous malignancy treated in the past two years. 7. patients unable to complete the questionnaires and six minute walks detailed in the study.women of child bearing potential unable to use adequate birth control as determined by the investigator.

Keywords: sarcoidosis, fibrosis, bronchiectasis
the perioperative management of anti-thrombotic drug registry

Conditions: Surgery; Perioperative/Postoperative Complications

Summary: the purpose of the study is to investigate contemporary antiplatelet therapy management of patients referred for non-cardiac and cardiac surgical procedures while on chronic therapy with antiplatelet and/or anticoagulant drugs. these medications are routinely prescribed to patients following percutaneous coronary interventions (pci), known diagnosis of atrial fibrillation, prosthetic heart valves, transcatheter aortic valve procedures, pulmonary embolism, deep vein thrombosis, peripheral artery revascularization procedures etc. this is a highly relevant and understudied clinical area with no randomized clinical trials or large-scale prospective evidence, except for bridging data with unfractionated heparin (ufh). most recommendations and guidelines are based on consensus expert opinion. while post-pci patients, especially those treated with coronary stents are placed on dual antiplatelet agents such as aspirin and p2y12 blocking agents, performing surgery while on these agents increase the risk of hemorrhagic complications, discontinuation or interruption of dual antiplatelet therapy (dapt) has been associated with adverse ischemic outcomes secondary to myocardial infarction (mi) and stent thrombosis (st). moreover, there is only no clear consensus regarding continuation of aspirin perioperatively in these patients. as in the case of pci, similar arguments for juxtaposed risks (thrombosis vs. bleeding) can be made for a myriad of clinical situations where chronic (≥45 days) use antiplatelet and anticoagulant medication (together referred to as antithrombotic drugs) are indicated. in addition, there are many procedures and surgeries with different bleeding and ischemic risks that cannot be studies through dedicated randomized studies and a registry collection of such information could provide valuable guidance to providers and patients worldwide.


Eligibility criteria:
inclusion criteria: * treatment with antiplatelet and/or anticoagulant medications for ≥45 days prior to the date of ncs. * patients with planned, urgent or emergent cardiac or non-cardiac surgery or procedure (cncs) exclusion criteria: * none

Keywords: anti-thrombotic drugs cardiac intervention non-cardiac intervention
body mass index, academic stress and musculoskeletal disorders relationships

Conditions: BMI, Academic Stress and MSDs Relationships

Summary: \[purpose\] to investigate the prevalence of musculoskeletal disorders among healthy students of ahlia university and to determine the relationship between the prevalence of musculoskeletal disorders and academic stressors and body mass index. \[subjects and methods\]: self-administered questionnaires were distributed to 94 students aged 18-26 years who were enrolled at various ahlia university colleges and met other inclusion criteria. the students responded to the standardized nordic musculoskeletal questionnaire and the modified college student stress inventory regarding musculoskeletal symptoms and academic stressors. height and weight measurements were also obtained to determine body mass index. keywords: body mass index, academic stress, musculoskeletal disorders

\[purpose\] to investigate the prevalence of musculoskeletal disorders among healthy students of ahlia university and to determine the relationship between the prevalence of musculoskeletal disorders and academic stressors and body mass index. \[subjects and methods\]: self-administered questionnaires were distributed to 94 students aged 18-26 years who were enrolled at various ahlia university colleges and met other inclusion criteria. the students responded to the standardized nordic musculoskeletal questionnaire and the modified college student stress inventory regarding musculoskeletal symptoms and academic stressors. height and weight measurements were also obtained to determine body mass index. keywords: body mass index, academic stress, musculoskeletal disorders

Eligibility criteria:
inclusion criteria: * a total of 28 male and 66 female students (age, 18-26 years; mean, 21 ± 1.9 years) from various ahlia university colleges were recruited to participate in this study. * to be included in the study, all subjects had to be enrolled in an undergraduate program at ahlia university, bahrain. * in addition, they had to be relatively healthy with no diagnosed medical conditions that would cause pain. exclusion criteria: * exclusion criteria were previous injury or trauma to body parts, any surgical intervention, history of psychological disorders prior to enrolment at the university, and severe physical disability causing pain. * in addition, students with blood disorders, such as sickle cell anaemia and thalassaemia, were excluded.

Keywords: body mass index academic stress musculoskeletal disorders